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Contact Information

BRENDA WIESE, MSW LICSW
1617 HWY 12 E, SUITE 230
WILLMAR, MN56201
 Phone: 320-894-2741
 Fax: 320-205-0030
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Mental Health

101YM0800X
Indicates primary specialty

NPI Profile & details for BRENDA WIESE · (Female)

NPI Number 1700294881
Status Active
Credentials MSW LICSW
Entity Individual
Enumeration date 08/01/2014
Last updated 08/01/2014 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • MN License # 8625
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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